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Heart Valve Replacement

Definition

This is surgery to replace a damaged heart valve. The heart's four valves open and tightly close. The tricuspid and mitral valves allow blood to flow from one chamber to another. The pulmonary and aortic valves allow blood to flow to the large blood vessels. The valves make it so that blood can only flow forward when the heart squeezes. Usually, only one valve is replaced at a time. However, at times, one or more valves may need to be replaced. The new heart valves can be:

Mechanical, made of metal and plastic, such as a St. Jude valve

Made of tissue—most commonly from a pig or a cow, but they may also be supplied by a human donor or even made from your own tissue

What to Expect

Prior to Procedure

Echocardiogram
—a test that uses sound waves to visualize functioning of the heart, including the valves

X-ray
—a test that uses radiation to take a picture of structures inside the body

Electrocardiogram
(EKG)—a test that records the heart's activity by measuring electrical currents through the heart muscle

Cardiac catheterization
—the insertion of a tube-like instrument into the heart through an artery to detect problems with the heart and its blood supply. It can also accurately define the valve problem.

Leading up to your procedure:

Talk to your doctor about your medications. You may be asked to stop taking some medications up to one week before the procedure.

Arrange for a ride to and from the hospital.

Arrange for help at home after the surgery.

Eat a light meal the night before the surgery. Do not eat or drink anything after midnight.

Anesthesia

General anesthesia
will be used. It will block any pain and keep you asleep through the surgery. It is given through an IV.

Description of the Procedure

The doctor will cut through the skin and breastbone. The chest cavity will be opened. Next, your heart will be connected to a heart-lung machine. This machine will take over the functions of the heart and lungs during the surgery. Next, the heart will be stopped. An incision will be made and the damaged valve will be removed. The new valve will be stitched into place. The doctor will check to make sure the valve opens and closes properly. The incision in the heart will be closed, and the heart will be restarted. After the heart is working fine, you will be removed from the heart-lung machine. The chest will be closed with wires. Lastly, the skin will be closed with sutures.

Immediately After Procedure

You will be closely monitored in the intensive care unit (ICU) with the help of the following devices:

A heart monitor

A breathing tube—until you can breathe on your own

Chest tubes—to drain excess fluids from the chest

A line into an artery in your arm or leg—to measure pressure

A tube through your nose and into the stomach—to keep the stomach drained of excess fluids and gas

An IV to deliver fluids and medications

A bladder catheter

How Long Will It Take?

3-5 hours—depending on how many valves need to be replaced

How Much Will It Hurt?

You will have pain while recovering. Your doctor will give you pain medication.

Average Hospital Stay

This procedure is done in a hospital setting. The usual length of stay is 2-5 days. The first day is spent in ICU. You may need to stay longer if complications occur.

Post-procedure Care

At the Hospital

While you are recovering at the hospital, you may be instructed to:

Breathe deeply and cough 10-20 times every hour to help keep your lungs working well.

Walk with assistance. You may be encouraged to walk 2-3 days after surgery.

Take blood thinners to prevent blood clots from forming around the valve. If you have a tissue valve, you will not need a blood thinner. If you have a mechanical valve, you will have to take the medication for the rest of your life.

At Home

When you return home, do the following to help ensure a smooth recovery:

Work with a physical therapist.

Be sure to follow your doctor’s
instructions.

Call Your Doctor

After you leave the hospital, contact your doctor if any of the following occurs:

Signs of infection, including fever and chills

Redness, swelling, increasing pain, excessive bleeding, or discharge from the incision site

Nausea and/or vomiting that you cannot control with the medications you were given after surgery, or which persist for more than two days after discharge from the hospital

Pain that you cannot control with the medications you have been given

Cough, shortness of breath, or chest pain

Coughing up blood

Rapid heart rate

Sudden headache or feeling faint

Problems with vision or speaking

Numbness or weakness on one side of your body

Inability to urinate

Pain, burning, urgency, frequency of urination, or persistent bleeding in the urine

Pain and/or swelling in your feet, calves, or legs

In case of an emergency, call for emergency medical services right away.

Revision Information

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.